Desperately Seeking Dental Care
Finding affordable dental care for people with diabetes
"Of all the systemic diseases that influence oral health, the greatest impact on oral health is seen in patients with diabetes mellitus," says Ira Lamster, D.D.S., M.M.Sc. Dean and Professor of Dental Medicine at Columbia University College of Dental Medicine in New York, NY. Diabetes is the only recognized systemic risk factor for periodontal disease. And evidence strongly suggests a two-way relationship because periodontal disease can negatively affect blood glucose levels. Many are so busy seeing multiple specialists they don't have time to see the dentist, Lamster explains, "This has been consistently observed in studies of dental utilization patterns by patients with diabetes mellitus." And then there are others who cannot afford dental care. In 2003, the US Surgeon General reported that nearly one-third of the U.S. population had no dental insurance, says Maria Emanuel Ryan, D.D.S., Ph.D., Professor of Oral Biology and Pathology at Stony Brook University School of Dental Medicine in Stony Brook, NY. "If we assume that the number is relatively similar today…and that at least 21 million Americans have some form of diabetes, then we could estimate that 7 million people with diabetes have no dental insurance," explains Ryan. Dentists are also reporting up to a 20 percent downturn in visits, suggesting that oral health is not a priority for cash strapped Americans.
First the good news. Health insurance companies, such as Aetna, Cigna, and Delta Dental, are paying closer attention to the relationship between certain health conditions and oral health, and have expanded their dental benefit coverage. Aetna, launched its Dental Medical Integration (DMI) program in 2007 following a long standing research partnership between Aetna and Columbia University that connected the dots between diabetes, heart disease, and pregnancy, and the benefit of regular dentist visits, says Mary Lee Conicella, D.M.D., F.A.G.D., Aetna Chief Dental Officer in Pittsburgh, PA. The plan covers extra cleanings and gum treatments for people with those conditions. "For instance, if someone with diabetes requires an extra cleaning they won't have to pay out of pocket," Conicella explains. The DMI program is available to Aetna subscribers with both medical and dental coverage. Individuals might be able to purchase medical plans with a "buy up" option for dental. Coverage will vary from state to state. For more specific information visit: http://www.aetna.com/plans-services-health-insurance/overview/dental-insurance/dental-insurance.html.
No matter who's got you covered, take the time to investigate the benefit plan through your individual health insurance company to find out the latest about their dental coverage for people with diabetes.
If you do not have a dental plan...
Try speaking with your dentist to see if you can arrange a payment plan for services. "Many dentists are willing to do this for their patients," says Burton Edelstein, D.D.S., M.P.H., Professor of Dentistry and Health Policy and Management at Columbia University in New York, NY, and President of the Children's Dental Health Project in Washington DC. If that isn't an option you might start with www.insurekidsnow.gov to search for federally funded insurance programs and providers for children. "The good news is that for qualifying children, state Medicaid and CHIP programs are federally mandated to provide comprehensive dental coverage," says Edelstein. Adults however have to dig around quite a bit. Not all health clinics and community health centers offer basic dental services, and there are no specific programs targeted to provide dental care for people with diabetes. To find dental services for adults try HRSA, the Health Resources and Services Administration (www.HRSA.gov). If you find a clinic in your area call first to make sure they still participate. You can also try the Dental Lifeline Network (www.nfdh.org). Click on Donated Dental Services, and then State DDS programs, to find a DDS coordinator in your state.
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